CERTIFICATION CHECKLISTS
Floodproofing, V-Zone Design &
Elevation Certificates from 1996 and 2000
NOTE : T he official checklist for the 2006, 2009, and 2012 Elevation Certificate is found in
Figure 310-2 of the 2013 CRS Coordinator’s Manual. An Elevation Certificate with the
checklist items highlighted is available on http://crsresources.org/files/
300/2012_ec_checklist_4-13.pdf.
Checklist for the Floodproofing Certificate
When required: For credit under element EC (Elevation Certificates) under Activity 310,
FEMA’s Floodproofing Certificate (FEMA Form 086-0-34) is required for any new or
substantially improved non-residential building in the Special Flood Hazard Area (SFHA)
that was floodproofed instead of elevated. Only one form is needed for each floodproofed
property. A separate Elevation Certificate is not needed.
Floodproofing checklist:
Property Information

Complete property address or lot/block number
Section I – FIRM information:







NFIP community number
Panel number
Panel number suffix
Date of FIRM index
Flood zone(s) in which the building is located
Base flood elevation(s)
Elevation datum for the BFE
Section II – Floodproofing information


Elevations are based on ___ (any one of the three is acceptable)
Building is floodproofed to an elevation of ___
 NGVD 1929 NAVD 1988 Other/Source:
 Height of floodproofing on the building above the lowest adjacent grade ___
 For Unnumbered A Zones Only: Highest adjacent (finished) grade next to the building (HAG)
 NGVD 1929 NAVD 1988 Other/Source:
Section III – Certification

Certifier’s name

Certifier’s signature

License number

Date
Checklist for Certificates
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May 28, 2013
Checklist for V-Zone Design Certificates
Note that the V-Zone design certificates certify the design of structures in the V Zone, and
must be used in conjunction with finished construction Elevation Certificates.
Property Information

Complete property address
Design Elevations

All elevations must be in a consistent vertical datum (preferably the same datum as the
community’s FIRM).

Base Flood Elevation (BFE)

Elevation of Bottom of Lowest Horizontal Structural Member

Elevation of Lowest Adjacent Grade (LAG)

Depth of anticipated scour/erosion used for foundation design

Embedment depth of pilings or foundation below Lowest Adjacent Grade
What the Signatory is Certifying: For ALL certified structures, the design professional has either
developed or reviewed the designs, plans, and specifications for the structure and found that the design
and methods of construction to be used are in accordance with accepted standards of practice for
meeting the following provisions:

The lowest horizontal structure is above the Base Flood Elevation (BFE)

The pile and column foundation and structure attached thereto is anchored to resist flotation,
collapse, and lateral movement due to the effects of the wind and water loads acting
simultaneously on all building components. Water loading values used are those associated with
the base flood. Wind loading values used are those required by the applicable State or local
building code. The potential for scour and erosion at the foundation has been anticipated for
conditions associated with the base flood, including wave action.
For certified structures with breakaway walls exceeding a design safe loading resistance of 20 pounds
per square foot:
The design professional has either developed or reviewed the structural design, plans,
and specifications for construction and that the design and methods of construction to be used for the
breakaway walls are in accordance with accepted standards of practice for meeting the following
provisions:

Breakaway wall collapse shall result from a water load less than that which would occur during
the base flood; and

The elevated portion of the building and supporting foundation system shall not be subject to
collapse, displacement, or other structural damage due to the effects of wind and water loads
acting simultaneously on all building components.
NOTE: It must be clear on the form that the design professional is or is not certifying the structure for
breakaway walls. Adding the text “if applicable” to the breakaway wall clause is not sufficient proof that
the walls have been certified.
Information on Design Professional

Name

Signature

License number

Date
Checklist for Certificates
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May 28, 2013
Checklist for the 1996 Elevation Certificate
Section A. Property Information—Complete address or other description of the property’s location,
such as a legal description.
Section B. Flood Insurance Rate Map (FIRM) Information
1.
2.
3.
4.
5.
6.
Correct
Correct
Correct
Correct
Correct
Correct
community NFIP number
panel number
suffix for the panel
date of FIRM index (not necessarily the same as the panel’s date)
FIRM zone
base flood elevation
Section C. Building Elevation Information
1. Correct building diagram number
2. Reference floor elevation completed
5. Certificate based on actual construction
6. Lowest adjacent grade elevation completed (except in AO Zones)
Section E. Certification—Name of registered engineer, architect, land surveyor or qualified local
official (or, for unnumbered A and V Zones, the owner); AND that person’s signature
Checklist for Certificates
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May 28, 2013
Checklist for the 2000 Elevation Certificate
SECTION A–PROPERTY OWNER INFORMATION
Complete street address or property description (2nd or 4th lines)
City, State, Zip code (3rd line)
SECTION B–FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
B1.
B4.
B5.
B6.
B7.
B8.
B9.
B10.
B11.
B12.
NFIP community name and community number
Map and panel number
Suffix
FIRM index date
FIRM panel effective/revised date
Flood zones(s) in which the building is located
Base flood elevation(s)
The source of the Base Flood Elevation (BFE) data or base flood depth entered in B9.
The elevation datum used for the BFE in B9
Whether the building is located in a Coastal Barrier Resources System area or Otherwise Protected Area
SECTION C–BUILDING ELEVATION INFORMATION (when a survey is required)
C1. Source of building elevations Note: “Finished construction” must be checked unless the building is
still under construction.
C2. Building Diagram Number
C3. Elevations items a), e), f), and g) must be recorded on every certificate, The other items must
be completed if the letter appears on the diagram on pages 6 and 7 of the instructions. If a line is
not applicable, then insert “N/A.” If the letters h) or I) do not appear for that diagram, then enter “0.”
SECTION D–SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION
Certifier’s name and license number
Certifier’s signature
The box at the end of Section C must have the certifier’s seal.
SECTION E–BUILDING ELEVATION INFORMATION (when a survey is not required in a Zone AO or a Zone A
without a base flood elevation)
E1. Building Diagram Number
E2. The top of the bottom floor
E3. For Building Diagrams 6–-8 with openings (see page 7), the next higher floor or elevated floor
(elevation b) of the building
E4. Zone AO only where there is no flood depth on the FIRM, elevation of the bottom floor
complies with the local ordinance
Note: If Section E is used, then Sections F or G must be completed.
SECTION G–COMMUNITY INFORMATION
G1. This must be checked if the information in Section C was copied from another certified
document.
If so, then the local official’s name and signature must be completed in G9.
G2. This must be checked if the local official completed Section E. If so, then the local official’s
name and signature must be completed in G9.
Checklist for Certificates
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May 28, 2013